Organization
CENTER STREET SEVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AJ BOYER (PRESIDENT)
(785) 820-6176
Entity
Organization
Contact information
Practice address
100 S CENTER ST, ASSARIA, KS 67416-5035
(785) 820-6176
Mailing address
PO BOX 302, ASSARIA, KS 67416-0302
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200737950A
—
KS
Enumeration date
10/21/2011
Last updated
04/24/2014
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